CN113855778B - Traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm blood type esophageal cancer - Google Patents
Traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm blood type esophageal cancer Download PDFInfo
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- CN113855778B CN113855778B CN202111112745.3A CN202111112745A CN113855778B CN 113855778 B CN113855778 B CN 113855778B CN 202111112745 A CN202111112745 A CN 202111112745A CN 113855778 B CN113855778 B CN 113855778B
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Abstract
The invention relates to a traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm blood type esophageal cancer, which can effectively solve the medication problem of spleen-kidney yang deficiency obstinate phlegm blood type esophageal cancer, and the technical scheme for solving the problem is that the traditional Chinese medicine is prepared from the following raw material medicines by weight: 6-12g of prepared aconite, 3-7g of cinnamon, 10-20g of codonopsis pilosula, 10-20g of prepared rehmannia root, 8-16g of ginger processed pinellia tuber, 1-4g of clove, 6-12g of ginger, 3-7g of garden balsam seed, 3-7g of subprostrate sophora, 1-4g of leech and 6-12g of prepared arisaema tuber.
Description
Technical Field
The invention relates to the field of medicines, in particular to a traditional Chinese medicine (Fugui guan Ditong granules) for treating spleen-kidney yang deficiency, obstinate phlegm and aeipathia blood type esophageal cancer.
Background
Esophageal Cancer (EC) is a common malignancy originating in the squamous and columnar epithelium of the esophagus, and symptoms of early esophageal cancer are generally not evident, often manifested as a foreign body sensation or gag sensation upon repeated swallowing of food, or post-sternal pain. Once the symptoms continue to appear or swallow food has obvious swallowing and gag feeling, the esophageal cancer is suggested to be in the late stage, the swallowing difficulty is gradually aggravated until water and saliva can not be swallowed, mucus-like phlegm is spitted, discomfort and pain are caused after the sternum, the body is extremely thin, the limbs are not warm, cold and intolerance are caused, the spirit is exhausted, but the people feel sleepy, the face is dark and white or sallow, little urine is produced, the tongue is pale and dark, the tongue is fat and large, the pulse is deep and weak, and the life quality of the patients is seriously influenced after the people grow on the long term.
Surgical treatment is one of main radical means of esophageal cancer, the surgical treatment of patients in early stage can achieve the purpose of radical treatment, patients in middle and late stage can carry out systemic treatment such as chemotherapy, targeted treatment, immunotherapy and the like, and meanwhile, local palliative surgical excision, local radiotherapy, esophageal stricture stent implantation and the like can be carried out to temporarily improve dysphagia symptoms; however, complications and adverse reactions caused by the disease damage the immune function of the organism, so that the treatment is difficult to continue, even the disease condition is aggravated, and finally the disease cannot tolerate systemic treatment such as chemotherapy and the like, thereby seriously affecting the life quality and prognosis of patients.
Esophageal cancer belongs to the category of dysphagia in traditional Chinese medicine. Dysphagia, obstruction; diaphragm patients do not eat the throat, and are rejected. The physician of all ages has detailed descriptions, as recorded in Jingyue quan Shu & Choi Jie: dysphagia is caused by anxiety, overstrain, depression, or excessive wine color. "Taiping Shenghui Fang" is recorded: it is also known as diaphragmatic qi because it is inappropriate to eat or drink food or anger because of anger and adverse qi, anxiety impairs heart to make yin and yang disharmony and oppression in chest and diaphragm. The pathogenesis of dysphagia is mainly manifested by unsmooth emotion, impairment due to alcohol and food, senile body weakness, deficiency of vital qi and the like, and the pathogenesis relates to various aspects of phlegm coagulation, qi depression, heat accumulation, blood stasis, deficiency of vital qi and the like. The traditional Chinese medicine has obvious treatment advantages, can obviously relieve the spleen-kidney yang deficiency and the pain of patients with obstinate phlegm blood type, improves the living quality and prolongs the life cycle of the patients, but the current traditional Chinese medicine research and preparation for treating the esophagus cancer belong to the blank, so that the traditional Chinese medicine particles for the patients with the spleen-kidney yang deficiency and the advanced esophagus cancer with the obstinate phlegm blood type are urgently needed to be researched and developed.
Disclosure of Invention
Aiming at the situation, in order to solve the defects of the prior art, the invention aims to provide the traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm blood group esophageal cancer, and can effectively solve the medication problem of spleen-kidney yang deficiency obstinate phlegm blood group esophageal cancer.
The technical scheme of the invention is that the traditional Chinese medicine is prepared from the following raw material medicines by weight: 6-12g of prepared aconite, 3-7g of cinnamon, 10-20g of codonopsis pilosula, 10-20g of prepared rehmannia root, 8-16g of ginger processed pinellia tuber, 1-4g of clove, 6-12g of ginger, 3-7g of garden balsam seed, 3-7g of subprostrate sophora, 1-4g of leech and 6-12g of prepared arisaema root, wherein the prepared aconite root, cinnamon, garden balsam seed, prepared rehmannia root, subprostrate sophora, leech and prepared arisaema are crushed and percolated by adding 5 times of ethanol with the volume concentration of 70 percent, the extract with the relative density of 1.2 is prepared by decompression and concentration at 50 ℃, the dregs of the 7 medicinal materials obtained in the steps are combined with the 4 medicinal materials of codonopsis pilosula, ginger processed pinellia tuber, clove and ginger and are decocted for 2 times by adding 5 times of water for 2 times of decoction, the decoction is combined for 2 times, the extract with the relative density of 1.2 is prepared by decompression and concentration at 50 ℃, drying, pulverizing into powder, adding adjuvant at a ratio of 1:2, mixing the powder and adjuvant at a ratio of dextrin-sugar powder of 1:1, adding 80% ethanol as wetting agent, making into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
The traditional Chinese medicine composition has scientific and reasonable compatibility, abundant raw materials, convenient taking and good effect, has the effects of warming yang and tonifying qi, reducing phlegm and removing stasis, and eliminating stagnation and removing choke, is effectively used for treating patients with late esophageal cancer, spleen-kidney yang deficiency and obstinate phlegm and blood type, and is an innovation of medicines for treating esophageal cancer.
Detailed Description
The following examples further illustrate the embodiments of the present invention in detail.
Example 1
When the invention is implemented, the invention can be prepared by the following raw material medicaments by weight: the preparation method comprises the following steps of crushing prepared monkshood, cinnamon 7g, cinnamon 4g, codonopsis pilosula 11g, prepared rehmannia root 11g, ginger processed pinellia tuber 9g, clove 2g, ginger 7g, garden balsam 4g, subprostrate sophora root 4g, leech 2g and prepared arisaema tuber 7g, percolating the crushed prepared monkshood, cinnamon, garden balsam, prepared rehmannia root, subprostrate sophora root, leech and prepared arisaema with 5 times of ethanol with the volume concentration of 70%, concentrating under reduced pressure at 50 ℃ to prepare an extract with the relative density of 1.2, mixing dregs of the 7 medicinal materials obtained in the above steps with the codonopsis pilosula, ginger processed pinellia tuber, clove and ginger 4 medicinal materials, adding 5 times of water, decocting for 2 times, mixing 2 times of decoction liquid, concentrating under reduced pressure at 50 ℃ to prepare the extract with the relative density of 1.2, drying, crushing into medicinal powder, adding auxiliary materials, mixing the medicinal powder and the auxiliary materials at a ratio of 1:2, wherein the auxiliary materials consist of dextrin-sugar powder of 1:1, taking ethanol with volume concentration of 80% as wetting agent, uniformly preparing into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
Example 2
When the invention is implemented, the invention can also be prepared from the following raw material medicaments in part by weight: 9g of prepared monkshood, 5g of cinnamon, 15g of codonopsis pilosula, 15g of prepared rhizome of rehmannia, 12g of ginger processed pinellia tuber, 3g of clove, 9g of ginger, 5g of garden balsam seed, 5g of subprostrate sophora, 3g of leech and 9g of prepared arisaema root, wherein the prepared monkshood, the cinnamon, the garden balsam seed, the prepared rhizome of rehmannia, the subprostrate sophora, the leech and the prepared arisaema root are crushed and are added with 5 times of ethanol for percolation, the ethanol with the volume concentration of 70 percent is decompressed and concentrated at the temperature of 50 ℃ to prepare an extract with the relative density of 1.2, dregs of the 7 medicinal materials obtained in the step are mixed with 4 medicinal materials of codonopsis pilosula, ginger processed pinellia tuber, clove and ginger, the 5 times of water is added for 2 times, the decoction is mixed for 2 hours each time, the decoction is decompressed and concentrated at the temperature of 50 ℃ to prepare the extract with the relative density of 1.2, the extract is dried and crushed into medicinal powder, auxiliary materials are added, the mixture ratio of the medicinal powder to the auxiliary materials is 1:2, and the auxiliary materials consist of dextrin-powdered sugar powder with the ratio of 1:1, taking 80% ethanol as wetting agent, making into soft mass, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
Example 3
When the invention is implemented, the invention can also be prepared from the following raw material medicaments in part by weight: 11g of prepared monkshood, 6g of cinnamon, 19g of codonopsis pilosula, 19g of prepared rhizome of rehmannia, 15g of ginger processed pinellia tuber, 3g of clove, 11g of ginger, 6g of garden balsam seed, 6g of subprostrate sophora, 3g of leech and 11g of prepared rhizoma arisaematis, wherein the prepared monkshood, the cinnamon, the garden balsam seed, the prepared rhizome of rehmannia, the subprostrate sophora, the leech and the prepared rhizoma arisaematis are crushed and are added with 5 times of ethanol for percolation, the ethanol with the volume concentration of 70 percent is decompressed and concentrated at the temperature of 50 ℃ to prepare an extract with the relative density of 1.2, dregs of the 7 medicinal materials obtained in the step are mixed with 4 medicinal materials of codonopsis pilosula, ginger processed pinellia tuber, clove and ginger, the 5 times of water is added for 2 times, the decoction is mixed for 2 hours each time, the decoction is decompressed and concentrated at the temperature of 50 ℃ to prepare the extract with the relative density of 1.2, the extract is dried and crushed into medicinal powder, auxiliary materials are added, the mixture ratio of the medicinal powder and the auxiliary materials is 1:2, the dextrin-powdered sugar powder, taking 80% ethanol as wetting agent, making into soft mass, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
Aiming at the esophagus cancer patients with spleen-kidney yang deficiency and obstinate phlegm and blood pertinence, the invention takes yang warming and qi benefiting, phlegm reducing and stasis removing, stagnation eliminating and choke dredging as rules of treatment, and monkshood has pungent, sweet and big heat flavor and can help heart yang, middle-temperature spleen yang and kidney yang at lower part, thus being the first medicine for restoring yang and relieving collapse. The book of materia Medica: the root of common monkshood daughter root, being pungent in flavor and warm in nature and good in property, is the essential herb for dredging twelve meridians and yang, and reaches the skin and hair but the exterior cold, the interior reaches the lower yuan but the aeipathia cold, all zang organs and all fu organs are full of all the internal components, and all the zang and Fu meridians are full of cold but no cure is available. The unprocessed radix aconiti lateralis is toxic and is mostly used externally, and after processing and processing, the toxicity of the processed radix aconiti lateralis is reduced, so that the safety and the effectiveness of medication are ensured, and the oral administration is convenient. The invention is used for patients with advanced esophageal cancer to choke in a choking process when eating, vomit a large amount of phlegm and saliva when eating, cause yin fluid loss, cause yin deficiency and yang impairment after long-term yin, extremely emaciation, cold limbs, cold and intolerance of cold, absently white or sallow complexion, little urine, pale and dark tongue, swollen and big tongue body and deep and thready pulse which are the symptoms of yang qi deficiency, and the patients need monkshood heat products to warm and tonify spleen and kidney and recover yang and rescue adverse qi. The book of property of medicine is recorded in the book: codonopsis pilosula can tonify spleen and lung, benefit qi and promote the production of body fluid; "materia medica justice" record: dangshen has the effects of tonifying spleen and nourishing stomach, moistening lung and generating body fluid, strengthening middle-jiao qi … …, invigorating spleen and transporting without dryness, nourishing stomach yin without stagnation, moistening lung without cold and cool, and nourishing blood without greasy taste. The codonopsis pilosula is sweet and neutral, and has the effects of tonifying spleen and qi, nourishing blood and promoting the production of body fluid, and is a tonifying medicine commonly used in traditional Chinese medicine and is a good medicine for tonifying qi; the medicine is mild in property, not dry and moist, not cold and not hot, and is a mild tonic, so the medicine is selected and used for treating choking during eating, poor appetite and weak spleen and stomach of patients with esophageal cancer so as to tonify qi and consolidate the constitution. Compendium of materia Medica: the prepared rehmannia root is used for filling bone marrow, growing muscle, generating essence and blood, tonifying internal injury deficiency of five internal organs, promoting blood circulation, benefiting ears and eyes, blackening beard and hair, treating five strains and seven injuries of men, treating middle and uterine bleeding of women, treating irregular menstruation and fetal birth diseases; lei Gong processing property of the drugs records in Li Zhong Zi: prepared rhizome of rehmannia is sweet and bitter in taste, warm in nature, non-toxic and enters heart, liver and kidney meridians. Promoting blood and qi circulation, sealing and filling bone marrow, nourishing kidney water, and tonifying yin. Shu Di Huang is the blood-tonifying agent, so it can enter heart, liver and blood-storing and blood-generating herbs. For example, in clinical application, radix rehmanniae Preparata is combined with radix Angelicae sinensis, rhizoma Ligustici Chuanxiong and radix Paeoniae alba to form a blood-enriching general formula-Siwu decoction for nourishing blood and tonifying deficiency and treating blood deficiency symptoms. Therefore, for esophageal cancer with extremely emaciation, abstinence and white or sallow complexion and deficiency of yin and blood caused by long-term illness, it is advisable to select prepared rehmannia root for nourishing kidney and enriching blood. Ben Cao Jing Shu (the book of materia Medica Prime and Dredging): it is also indicated for cold in heart and abdomen, cholera and spasm of muscles, lumbago, abortion, warming middle energizer, strengthening tendons and bones, blood circulation promoting … … with abdominal pain in autumn and winter due to cold, nourishing life gate, benefiting fire and eliminating yin, and Rou Gui; the book Ben Cao Hui Yan (treatise on materia Medica): rou Gui is also indicated for the cold of the pertinacious illness. Cinnamon, pungent and sweet, large heat, entering kidney, spleen, heart and liver meridians, can tonify fire, strengthen yang, dispel cold, alleviate pain, warm and dredge meridians and vessels, induce fire to return to original origin. The qi roots of the human body are from kidney primordial qi, the yang qi is from kidney yang, the yang qi deficiency of patients with esophageal cancer reaches the kidney for a long time, and the cinnamon warms the kidney and regulates qi; fu Zi and Rou Gui are both interior-warming herbs and enter kidney meridian, and they are mutually reinforced to strengthen the effect of warming and tonifying kidney yang, so they are indicated for yang qi deficiency syndrome. The herbal Meng quan: "Xiang … … can stop one of qi and the adverse flow of qi"; the book materia Medica is as follows: clove warms middle and fast qi. For hiccup due to upper energizer, it can remove stomach cold and dysentery, seven emotions and five depression. "clove: pungent and warm herbs enter spleen, stomach and kidney meridians, and they are interior-warming herbs. The invention is used for choking during choking and spitting a large amount of mucus sticky strips in esophageal cancer, and the clove has the functions of warming spleen and stomach, lowering adverse qi, warming kidney and tonifying yang, and can lower adverse qi, stop vomiting and warm phlegm and retained fluid. The book "treatise on drug properties" is characterized in that: pinellia ternate's rhizoma pinelliae ' has the effects of eliminating phlegm and salivation, stimulating the appetite, strengthening the spleen, stopping vomiting, removing phlegm fullness in the chest, descending lung qi and mainly treating cough and nodulation '; cloud of main treatment secret essences: pinellia ternate has the effects of drying stomach dampness, reducing phlegm, tonifying spleen and stomach qi, reducing swelling, resolving masses and removing phlegm and saliva in chest. Unprocessed ban Xia is toxic, and the processed ginger ban Xia has reduced toxicity and warm and dry property. The ginger-processed pinellia tuber is used for patients with esophageal cancer who eat unsmooth food or vomit phlegm and saliva immediately after eating, and selects ginger-processed pinellia tuber for eliminating dampness and phlegm, and calming adverse-rising energy and preventing vomiting. The original menstrual period was: tian nan xing, also known as Hu Zu from Ben Jing. Is a special herb for treating wind-phlegm; the book Jing: tian nan xing is also indicated for heart pain, cold and heat and accumulation of qi, i.e. promoting qi flow and benefiting chest and diaphragm from Kai Bao. For mass accumulation in the bent beam, it is … … in breaking hardness accumulation in Kaibao in Ben Jing. The rhizoma arisaematis has strong irritant toxicity, and can be processed with rhizoma Zingiberis recens and Alumen to achieve toxicity reducing/synergistic effect, and processed into processed product, named rhizoma arisaematis preparata. The Chinese pharmacopoeia records: rhizoma arisaematis preparata, bitter, pungent and warm; toxic, entering lung, liver and spleen meridians, has the effects of drying dampness, resolving phlegm, dispelling wind, relieving spasm, resolving masses and relieving swelling. Rhizoma arisaematis can eliminate dampness and phlegm, and also can dissipate stagnation and relieve swelling, and can be used for treating esophageal cancer, emesis, phlegm and saliva, and unsmooth eating; it is combined with Jiang ban Xia to strengthen the action of drying dampness and resolving phlegm. Ben Cao Jing Shu (the book of materia Medica Prime and Dredging): hirudo, salty in taste, bitter in flavor and even in smell, with great toxicity … … salty in blood to remove blood, bitter in flavor to purge stagnation, and salty and bitter in flavor to accompany, is indicated for women with blood stasis, amenorrhea and blood obstruction, so it is not suitable for children. "(the summary of the present materia Medica): leeches, herbs for expelling malignant blood and blood stasis. The leech is a medicine for promoting blood circulation and removing blood stasis, has stronger effects of breaking blood and removing blood stasis, such as the famous prescription for treating blood stasis-Zhentong decoction, is composed of leech, gadfly, peach kernel and rhubarb, has the effects of breaking blood and removing blood stasis and causing new aging, is a drastic agent for breaking blood and removing blood stasis, and has wide clinical application and obvious effect. In the late stage of esophageal cancer, the disease is ill, the disease position is deep and prone, blood stasis is long, aeipathia is formed, products which are not removed by worms cannot be introduced to the disease position, and leeches are selected to break blood and remove stasis, dissipate stagnation and remove stasis. The garden balsam is dry mature seed of garden balsam, which is recorded in ancient books as garden balsam and garden balsam, and the Lishizhen 'Bencao compendium' describes garden balsam which is slightly bitter, warm and slightly toxic, and can be used for 'difficult birth, mass accumulation and dysphagia, lower bone choking, bone penetrating and resuscitation', and the garden balsam can penetrate bone and soften hard masses because of rapid nature. It is proved that cooked fish is hard and easy to be softened by a few grains. "Chinese pharmacopoeia" records: acute seed: slightly bitter, pungent and warm; has little toxicity. Enter lung and liver meridians, break blood, soften hard mass and remove food retention. Can be used for treating abdominal mass, amenorrhea, and dysphagia. Therefore, the medicine is good for treating esophageal cancer with the symptoms of phlegm dissolving and blood stasis of the garden balsam. "Kaibao Ben Cao" (open materia Medica): the subprostrate sophora root can relieve the toxicity of various medicines and relieve pain. To eliminate sore, yellow, fever and cough, and kill worms; the book of drawings says that the decoction for throat containing has the effect of relieving sore throat and throat swelling toxin and is extremely wonderful; record of materia medica claim true: the main herb of the subprostrate sophora is bitter and cold, has the effect of purging heart and protecting lung, and can reduce yin channel adverse-rising of fire and relieve sore throat. Subprostrate sophora root: bitter taste and cold nature, entering lung and stomach meridians; the functions are as follows: clearing away heat and toxic material, relieving swelling and relieving sore throat. According to the report of the literature, the subprostrate sophora has the inhibiting effect on various tumors such as esophageal cancer, liver cancer, lung cancer and the like. The invention aims at unsmooth eating, choking feeling and esophagus gall of patients with esophageal cancer, and selects vietnamese sophora root which can reduce swelling, eliminate stagnation, improve eating, choking and choke, clear heat, detoxify and relieve the esophagus gall. Ginger is the "holy medicine for vomiting family". The book of medical science: fresh ginger is pungent and flee, and medicinal herbs are good at eliminating phlegm and promoting defecation and urination, stopping vomiting due to cold, removing foul smell and promoting the restoration of consciousness. Fresh ginger, pungent in flavor and slightly warm in nature, enters lung, spleen and stomach meridians. The invention is used for treating esophageal cancer, unsmooth eating with vomiting phlegm and saliva, and is matched with ginger to harmonize stomach, regulate qi, warm middle energizer and arrest vomiting.
The eleven traditional Chinese medicines are prepared from the whole formula of the granule, namely the monkshood root and the radix codonopsitis, and the monkshood can warm and tonify spleen and kidney, and the codonopsis pilosula can tonify qi and consolidate constitution and is the monarch medicine; prepared rehmannia root, radix rehmanniae Praeparata nourishes the kidney and enriches the blood, and cinnamon bark, cortex Cinnamomi and radix rehmanniae Praeparata are ministerial drugs for warming the kidney and regulating qi-flowing; flos Caryophylli has effects of lowering adverse qi and regulating stomach function, rhizoma Pinelliae Preparada has effects of eliminating dampness and phlegm, Hirudo dispelling blood stasis and breaking nodule, rhizoma arisaematis cum bile, semen Impatientis has effects of eliminating phlegm and resolving hard mass, and radix Sophorae Tonkinensis has effects of removing toxic substance and resolving hard mass as adjuvant; sheng Jiang can regulate stomach and qi. The medicine is scientific in use, proper in compatibility, and combined in use, has the effects of warming yang and tonifying qi, reducing phlegm and removing blood stasis, and removing stagnation and removing dysphagia, has obvious clinical curative effect, has the characteristics of safe use, stable and reliable curative effect and no toxic or side effect compared with other western medicine treatments and other common traditional Chinese medicine preparations, and obtains very good beneficial technical effects through tests and use, and relevant clinical test data are as follows:
first, clinical research
1. Diagnostic criteria:
1.1 Western diagnostic standards
All tested patients were diagnosed with esophageal squamous carcinoma after definite pathological diagnosis. The imaging stage refers to the latest version of the standard of esophageal cancer TNM stage (8 th version) of the international anticancer consortium (AJCC) issued in 2017.
2.2 Chinese medicine diagnostic Standard
Reference is made to the formulation standard of esophageal cancer syndrome in the national level planning teaching material of traditional Chinese medicine oncology published by Chinese traditional medicine publishing agency in 2011 in general higher education, and the traditional Chinese medicine typing standard of esophageal cancer commonly recognized by experts in multiple industries in China.
Spleen-kidney yang deficiency, obstinate phlegm and blood:
and (3) master certificate: choking sensation without eating, spitting clear foam, pale and fat tongue with little coating, and deep, thready or weak pulse.
And (3) concurrent evidence: pale complexion, lassitude, hypodynamia, qi deficiency, cold and aversion to cold, edema of the face or both lower limbs, and abnormal stool.
The basis of diagnosis is as follows: firstly, food can not be eaten; secondly, there is slight, moderate or severe choking feeling; ③ spitting water or saliva or thin sputum or foam; fourthly, the complexion is pale or the body is weak and the qi is little; fifthly, the shape is cold and feared; sixthly, edema of the face or the two lower limbs; seventhly, abnormal stool; the tongue is pale and swollen, has little coating, and the pulse is deep, thin or weak.
The diagnosis can be carried out by adding 2 items of the first item, the second item and the third item and 2 items of the fourth item, the fifth item, the sixth item, the seventh item and the eighth item.
2. And (3) inclusion standard:
the patients are diagnosed in the Henan province of TCM, tumor hospitals in Henan province of China, the first subsidiary hospital of Henan university of TCM, the first subsidiary hospital of Henan university of science and technology, the third subsidiary hospital of Henan university of TCM, the third subsidiary hospital of Lin county city of TCM, the Nanyang Zhongjing hospital, and the Jiaxian institute of TCM 8 hospitals during the clinical pathology diagnosis of esophageal squamous carcinoma at stage III and IV, and the patients can not be treated by surgery, radiotherapy, chemotherapy or after treatment, and can not be treated by radiotherapy, chemotherapy and the like again, and the patients with spleen-kidney yang deficiency and obstinate phlegm-blood syndrome in TCM syndrome differentiation belong to 44 cases of patients with obstinate phlegm-aeipathia.
3. The treatment scheme comprises the following steps:
the FUGUIGUANSHITONG granule prepared in example 2 of the present invention is taken on the basis of conventional symptomatic and nutritional support treatment.
The medicine taking method comprises the following steps: the preparation is administered by 3 times per day, each time is melted with 150-.
The taking course of treatment is as follows: the continuous administration for 42 days is a course of treatment, and the administration can be continued after 3-5 days.
Medication contraindication: smoking cessation, alcohol restriction, fasting with spicy stimulation and overheating with too hot food.
4. And (3) evaluating the curative effect:
1) survival rate of 42 days after treatment
2) Evaluation of quality of Life of tumor patients
5. Statistical treatment:
SPSS 21.0 statistical analysis software is adopted, continuous variables in baseline data of a patient are represented by mean +/-standard deviation or median (interquartile distance), sample data are subjected to normality test and homogeneity test of variance, a person who accords with normal distribution adopts t test analysis, and the data of a skewed state data or an unknown distribution type can be subjected to non-parametric test; the statistical result has statistical significance when P is less than 0.05.
6. The experimental results are as follows:
(1) comparison of baseline data:
patients meeting the nanocriterions were included as subjects in a group of 44, 27 men, 17 women, age (71.26 + -8.87) years, course (9.5 + -17) months, and 9 abscission cases.
(2) Patient pre-and post-treatment Ka's score comparison
The difference of the Ka-shi scores of the patients before treatment has no statistical significance (P is more than 0.05) through a t test, and the Ka-shi scores of the patients after treatment have no obvious difference (P is more than 0.05) compared with the Ka-shi scores before treatment. (see Table 1)
TABLE 1 comparison of Carlsberg scores before and after treatment of patients
Note: p > 0.05 compared to pre-treatment.
(3) Quality of life (QOL) assessment of tumor patients before and after treatment comparison:
the evaluation table difference of the tumor patients before treatment (QOL) has no statistical significance (P is more than 0.05), and the evaluation of the tumor patients after treatment (QOL) is obviously improved compared with that before treatment (P is less than 0.05).
TABLE 2 QOL comparison (M + -Q) before and after patient treatment
Note: p <0.05 compared to pre-treatment.
(4) The traditional Chinese medicine syndrome integral comparison before and after the treatment of the patient:
before treatment, the integral of dysphagia, pain after sternum, mucus vomiting, anorexia and listlessness of a patient has no statistical significance (P is more than 0.05), and after treatment, mucus vomiting, anorexia and listlessness are all obviously reduced (P is less than 0.05) compared with before treatment. Difficulty in swallowing and pain after sternum have no obvious difference (P is more than 0.05).
TABLE 3 integral comparison of symptoms of traditional Chinese medicine before and after treatment (M + -Q)
Note: p > 0.05, Δ P < 0.05;
(5) patient survival rate for 42 days: the survival rate of 35 patients taking the radix aconiti lateralis preparata-cinnamon-pipe-feeding granules is evaluated in 42 days, 4 patients die, and the clinical survival rate in 42 days is 88.57%.
No obvious adverse reaction and abnormality are seen in the whole treatment process.
Through long-term clinical practice, the traditional Chinese medicines prepared in other embodiments can achieve the same or similar treatment effects after being taken, and the detailed description is omitted.
Second, typical medical record
Medical record one
The patient is a beginner in 3 and 16 months in 2020. The main complaints are: choking during eating, unsmooth swallowing and choking, sticky mucus and phlegm spitting sometimes accompanied by pain; slight movement feeling, chest oppression, asthma, cough, and white and abundant sputum. The patient had done esophageal qi barium double contrast prompt in 1 month of 2020: the middle tube wall of the esophagus is stiff, irregular and narrow, and is full and defective, and the length of a focus is 5 CM. Esophagoscopy and biopsy, pathological report as squamous cell carcinoma, western diagnosis: and the squamous cell carcinoma in the middle esophagus is in stage III, and bronchial asthma and emphysema are diagnosed at the same time. The patients with serious lung diseases and weak constitution can not be operated or treated with chemotherapy. According to the symptoms of unsmooth choking during eating, sticky sputum, chest pain, hiccup, dark and tardy complexion, emaciation, dysphoria, chest stuffiness and asthma caused by slight movement, cough with white and colorful sputum, and thin stool for 3-5 times a day; pale and dark with greasy coating, thready and rapid pulse. Traditional Chinese medicine diagnosis: dysphagia and lung distension. The syndrome is spleen-kidney yang deficiency and obstinate phlegm blood type. For it is good at warming and tonifying spleen and kidney, resolving phlegm and removing blood stasis, opening the tube and dissipating nodulation. Selecting FUGUI DIEDITONG granule, 1 dose per day. The medicine is taken by 3 times, each time is melted by 150-200 ml of boiled water, the medicine is taken 1 hour after a meal, during the medicine taking period, the call is followed every week, the patient can get better after describing the medicine, the effect is not better, and the patient is ordered to continue taking the medicine according to the above.
And 2, second diagnosis in 2020, 4, 27 days: after the traditional Chinese medicine is taken, choking during eating can be relieved, symptoms such as choking in chest, asthma and cough are obviously improved, but symptoms such as cough, white and sticky sputum are still existed, and symptoms such as pharyngalgia, light mouth, tastelessness in eating, pale and dark tongue, white and slightly greasy fur and deep and thin pulse are accompanied. Decoct 30 doses of the above-mentioned herbs and take the decoction as before. Advising the patient to prevent wind and cold, and keep the mood pleasant.
Three diagnoses in 6 months and 28 days in 2020: choke in choking is relieved, but unsmooth eating still exists, chest distress and asthma basically disappear, cough with expectoration is well changed, and sometimes, the phlegm is too much, and the mouth is dry, the mouth is bitter, the pharyngalgia, the nausea and the like exist; pale tongue with white coating and deep pulse. Through the treatment, the constitution of the patient is obviously improved.
According to the language: after eight or eight years, the patients have a weak constitution, and are often suffered from a plurality of viscera dysfunction such as spleen, lung and kidney due to the addition of long-term smoking and drinking, irritability and irregular life. Frequent drinking of pungent substances such as alcohol easily causes local injury of the esophagus, and in addition, spleen-kidney yang deficiency and fluid loss due to warming and transformation can not be relieved for a long time to cause phlegm and blood stasis, which aggravates local pathological changes of the esophagus to cause dysphagia. The whole formula has the effects of strengthening spleen and kidney, warming yang and regulating qi, and eliminating phlegm and activating blood stasis, the patients have the constitution after the second diagnosis, all symptoms are relieved, and the patients are regulated by taking the traditional Chinese medicine as a main part, so that the spleen qi is healthy, the kidney yang is warm, and phlegm and blood stasis are gradually accumulated, the aim of eliminating pathogenic factors without damaging the body resistance is fulfilled, and the life quality is obviously improved.
Medical record 2
The patient is in a certain range, female, 79 years old, and initial diagnosis is carried out in 6 months and 3 days in 2020: the main complaints are: unsmooth swallowing, obvious choking feeling, little fluid diet, large spitting of phlegm and saliva, pale complexion, cold limbs, extreme emaciation, difficulty in falling asleep, abnormal stool, pale and white tongue, white and greasy tongue coating, and thready and weak pulse. History of minute questions: in 3 months of 2020, patients were diagnosed with unsmooth choking in the choking area in the local hospital, examined for gastroscopy and biopsied, and then confirmed to be stage III squamous cell carcinoma in the middle of the esophagus. The patients are old and only need to be nourished and treated according to the symptoms at the time. After that, choking symptoms of the patient eating are further aggravated, and the patient has chest pain at the bottom of 5 months in 2020, and has chest CT examination in a local hospital, and prompts that: 1. the occupation of the middle section of the esophagus is avoided, and severe stenosis is caused; 2. double lung nodules, suggested follow-up; 3. the upper mediastinal right posterior swollen lymph node, consider metastasis; 4. right 4 th rib bony destruction, consider metastasis; 5. gallstone. Squamous cell antigen 7.69 ng/ml. And (3) Western diagnosis: squamous cell carcinoma in the middle esophagus with lymph node metastasis and bone metastasis is stage IV. According to the symptoms of severe choking during swallowing, massive sputum and saliva, cold limbs, extreme emaciation of the body, chest pain, pale tongue with white greasy fur, slippery water, thready and weak pulse and the like of a patient, the outpatient service evaluates the life Quality (QOL) of a tumor patient: and 41 points. Traditional Chinese medicine diagnosis: dysphagia. Yang-deficiency of the spleen and kidney, the pattern of obstinate phlegm and blood. For it is suitable to warm and tonify spleen and kidney, recover yang and rescue collapse, resolve phlegm and remove stasis, open the tube and dissipate nodulation. The FUGUITUOTONG granule is administered at a dose of 1 dose per day in 3 times, and is administered after 1 hr after being thawed with 200 ml of 150-.
Second diagnosis in 6 months and 13 days in 2020: after the traditional Chinese medicine is taken, the swallowing disorder is relieved to some extent, the phlegm and the saliva begin to be reduced, half fluid food can be fed, the soft noodles are eaten 4 times every day, the four limbs are warmed, the chest pain is relieved, the spirit is improved, the sleep is improved before, the stool is not abnormal, the tongue is pale, the coating is white and slightly greasy, the pulse is deep, and the front is forceful. Tumor patients quality of life (QOL) assessment: 50 minutes, continuously decocting for 15 days, and except for half liquid food, warmly taking not less than 500 milliliters of milk, two egg custards, 2 two meat purees and 5 two vegetable purees every day in a grading way, keeping a happy mood, properly walking and sufficiently sleeping.
Three diagnoses in 6 months and 30 days in 2020: after the traditional Chinese medicines are decocted and the diet is strengthened for conditioning, choking of the patient during eating is further reduced, the symptoms of spitting and salivation basically disappear, the eating quantity is obviously increased, the chest pain is reduced, the physique is obviously improved, the patient can sleep, the patient can have normal stools, the tongue is reddish, the tongue coating is white and slightly greasy, and the pulse is deep. Already on-home, tumor patients' quality of life (QOL) assessments: the preparation is decocted in water for oral administration at 60 min, and the administered dose is 1 dose per day, and is taken warm twice in the morning and evening.
Four diagnosis in 7-month and 30-day in 2020: the food intake is basically smooth, and the semi-fluid food is mainly taken as the food. Food intake is increased, weight is increased by 3 kilograms, chest is painful, complexion is good and glossy, sleep is good, stool and urine are normal, tongue is light red, the coating is thin and white, and the pulse is deep. Has already been able to go out for activity. Tumor patients quality of life (QOL) assessment: and 75 minutes. Patients are reluctant to do esophagoscopy. Recheck the chest CT, and prompt: 1. the occupation of the middle section of the esophagus is reduced compared with the 5 months in 2020; 2. the double lung nodules were unchanged from the anterior; 3. bone destruction of the right 4 th rib was not progressive compared to the anterior; 4. gallstone. Squamous cell antigen 1.90 ng/ml. Order it to be taken according to the above formula to consolidate the curative effect.
According to the language: the patient had obvious choking symptoms at 3 months before the visit of traditional Chinese medicine, and had a definite diagnosis of squamous cell carcinoma in the middle part of the esophagus by looking up a gastroscope and taking a biopsy. Suggesting that the patient is at a middle or advanced stage. However, due to the failure of effective treatment, in addition, the patients are nearly 80 years old, have weak vital qi and insufficient visceral functions, especially have dysfunction of acquired spleen in transport, insufficiency of congenital kidney yang and weakness, long-term accumulation of phlegm and retained blood stasis and stubborn phlegm and blood stasis, and have become stubborn phlegm and blood stasis, so that local cancer foci of the esophagus are continuously enlarged, swallowing choking occurs, and a large amount of phlegm and saliva are vomited; yang deficiency of the spleen and kidney, failure of the body to warm and nourish, cold limbs, pale complexion, and extreme emaciation; old people have kidney failure and bone marrow malnutrition, and phlegm stasis cancer toxin enters the bone part to cause bone destruction; the pale tongue with white, greasy and slippery coating, thready and weak pulse are the symptoms of yang qi deficiency, blood vessel insufficiency and cold-dampness exuberance. When the patient is in the critical stage of vital qi deficiency and pathogenic factor exuberance, the treatment mainly warms and tonifies spleen and kidney, returns yang and relieves the patient from collapse, the cinnamon-attached food dredging particles are selected, the patient adopts the treatment scheme for 10 days to two times, the whole condition and local food intake are improved, the effect is not more, meanwhile, the patient is guided to strengthen diet recuperation, milk, egg custard, muddy flesh and muddy vegetables are added every day, the patient is encouraged to cooperate with the treatment, and the confidence is increased. The overall condition and the eating condition of the patient are obviously improved in the three diagnostic methods, the grade of the life quality is gradually increased, the functions of the liver, the spleen and the kidney are recovered, the symptoms of the patient are effectively relieved, and the life quality is improved.
The traditional Chinese medicine granule has scientific and reasonable compatibility, abundant raw materials, convenient taking and good effect, has the effects of warming yang and tonifying qi, reducing phlegm and removing blood stasis, and eliminating stagnation and removing choke, can obviously relieve clinical symptoms of choking and the like of patients with spleen-kidney yang deficiency and obstinate phlegm blood type esophageal cancer, provides a safe and effective traditional Chinese medicine granule, and has good popularization and application values and practical clinical significance.
Claims (4)
1. The traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm type esophageal cancer is characterized by being prepared from the following raw material medicines in parts by weight: 6-12g of prepared aconite, 3-7g of cinnamon, 10-20g of codonopsis pilosula, 10-20g of prepared rehmannia root, 8-16g of ginger processed pinellia tuber, 1-4g of clove, 6-12g of ginger, 3-7g of garden balsam seed, 3-7g of subprostrate sophora, 3-7g of leech, 1-4g of leech and 6-12g of prepared arisaema root, wherein the prepared aconite root, the cinnamon, the garden balsam seed, the prepared rehmannia root, the subprostrate sophora, the leech and the prepared arisaema tuber are crushed and added with 5 times of ethanol with the volume concentration of 70 percent for percolation, the extract with the relative density of 1.2 is prepared by decompression and concentration at 50 ℃, the dregs of decoction of the 7 medicinal materials obtained in the steps are combined with the 4 medicinal materials of codonopsis pilosula, ginger processed pinellia tuber, clove and ginger for 2 hours each time, the decoction obtained by 2 times is combined, the extract with the relative density of 1.2 is prepared by decompression and concentration at 50 ℃, the drying, pulverizing into medicinal powder, adding adjuvant at a ratio of 1:2, wherein the adjuvant comprises dextrin-sugar powder =1:1, ethanol with volume concentration of 80% as wetting agent, making into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
2. The traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm aeipathia blood type esophageal cancer according to claim 1, which is prepared from the following raw medicines in parts by weight: the preparation method comprises the following steps of crushing prepared monkshood, cinnamon 7g, cinnamon 4g, codonopsis pilosula 11g, prepared rehmannia root 11g, ginger processed pinellia tuber 9g, clove 2g, ginger 7g, garden balsam 4g, subprostrate sophora 4g, leech 2g and prepared arisaema tuber 7g, adding 5 times of ethanol with the volume concentration of 70% for percolation, carrying out reduced pressure concentration at 50 ℃ to prepare an extract with the relative density of 1.2, mixing dregs of the 7 medicinal materials obtained in the previous step with the codonopsis pilosula, ginger processed pinellia tuber, clove and ginger 4 medicinal materials, adding 5 times of water for decocting for 2 times, each time for 2 hours, mixing 2 times of obtained decoction liquid, carrying out reduced pressure concentration at 50 ℃ to prepare the extract with the relative density of 1.2, drying, crushing into medicinal powder, adding auxiliary materials, mixing the medicinal powder with the auxiliary materials according to the ratio of 1:2, forming dextrin-powdered sugar =1:1 by the auxiliary materials, using the ethanol with the volume concentration of 80% as a wetting agent, uniformly preparing into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
3. The traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm aeipathia blood type esophageal cancer according to claim 1, which is prepared from the following raw medicines in parts by weight: the preparation method comprises the following steps of crushing prepared monkshood, cinnamon 9g, cinnamon 5g, codonopsis pilosula 15g, prepared rehmannia root 15g, ginger processed pinellia tuber 12g, clove 3g, ginger 9g, garden balsam 5g, subprostrate sophora, leech 3g and prepared arisaema tuber 9g, percolating the crushed prepared monkshood, cinnamon, garden balsam, prepared rehmannia root, subprostrate sophora, leech and prepared arisaema with 5 times of ethanol with the volume concentration of 70%, concentrating under reduced pressure at 50 ℃ to prepare an extract with the relative density of 1.2, mixing dregs of the 7 medicinal materials obtained in the previous steps with codonopsis pilosula, ginger processed pinellia tuber, clove and ginger 4 medicinal materials, adding 5 times of water, decocting for 2 times, mixing 2 times of decoction liquid, concentrating under reduced pressure at 50 ℃ to prepare an extract with the relative density of 1.2, drying, crushing into medicinal powder, adding auxiliary materials, wherein the ratio of the medicinal powder to the auxiliary materials is 1:2, the auxiliary materials comprise dextrin-powdered sugar =1:1, and 80% ethanol as a wetting agent, uniformly preparing into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
4. The traditional Chinese medicine for treating spleen-kidney yang deficiency obstinate phlegm aeipathia blood type esophageal cancer according to claim 1, which is prepared from the following raw medicines in parts by weight: 11g of prepared monkshood, 6g of cinnamon, 19g of codonopsis pilosula, 19g of prepared rhizome of rehmannia, 15g of ginger processed pinellia tuber, 3g of clove, 11g of ginger, 6g of garden balsam seed, 6g of subprostrate sophora, 3g of leech and 11g of prepared arisaema, wherein the prepared monkshood, the cinnamon, the garden balsam seed, the prepared rehmannia root, the subprostrate sophora, the leech and the prepared arisaema are crushed and added with 5 times of ethanol for percolation, the ethanol with the volume concentration of 70 percent is decompressed and concentrated at 50 ℃ to prepare an extract with the relative density of 1.2, dregs of the 7 medicinal materials obtained in the steps are mixed with 4 medicinal materials of codonopsis pilosula, ginger processed pinellia tuber, clove and ginger, the 5 times of water is added for 2 times, the decoction is mixed for 2 hours each time, the decoction is mixed for 2 times, the extract with the relative density of 1.2 is prepared by decompressing and concentrating at 50 ℃, the drying and crushing into medicinal powder, auxiliary materials are added, the mixture ratio of the medicinal powder and the auxiliary materials is 1:2, the dextrin-powdered sugar =1:1, the ethanol with the volume concentration of 80 percent of the wetting agent, uniformly preparing into soft material, sieving with 20 mesh sieve, granulating, drying at 60 deg.C, sieving with 14 mesh sieve, granulating, and packaging to obtain granule.
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| CN1544047A (en) * | 2003-11-17 | 2004-11-10 | 彭厚平 | Chinese traditional medicine composition for treating cancer and its preparation |
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